• 1.

    National Hospital Ambulatory Medical Care Survey: 2010 ED Summary Tables, p 21. Available at: http://www.cdc.gov/nchs/data/ahcd/nhamcs_emergency/2010_ed_web_tables.pdf. Accessed October 31, 2013.

    • Search Google Scholar
    • Export Citation
  • 2.

    Chan KW, Ding BC, Mroczek KJ: Acute and chronic lateral ankle instability in the athlete. Bull NYU Hosp Jt Dis 69: 17, 2011.

  • 3.

    Berlet G, Anderson RB, Davis W: Chronic lateral ankle instability. Foot Ankle Clin 4: 713, 1999.

  • 4.

    Slater HK: Acute peroneal tears. J Foot Ankle Clin 12: 659, 2007.

  • 5.

    Karlsson J, Wiger P: Longitudinal split of the peroneus brevis tendon and lateral ankle instability: treatment of concomitant lesions. J Athl Train 37: 463, 2002.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 6.

    Zammit J, Singh D: The peroneus quartus muscle: anatomy and clinical relevance. J Bone Joint Surg Br 85: 1134, 2003.

  • 7.

    Wang XT, Rosenberg ZS, Mechlin MB, et al: Normal variants and diseases of the peroneal tendons and superior peroneal retinaculum: MR imaging features. Radiographics 25: 587, 2005.

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 8.

    Coughlin MJ, Mann RA, Saltzman CL: “Disorders of Tendons,” in Surgery of the Foot and Ankle, Vol 1, p 1188, Mosby, St. Louis, 2007.

  • 9.

    Sobel M, Geppert MJ, Olsen EJ, et al: The dynamics of peroneus brevis tendon splits: a proposed mechanism, technique of diagnosis, and classification of injury. Foot Ankle 13: 413, 1992.

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 10.

    Sammarco GJ, Diraimondo CV: Chronic peroneus brevis tendon lesions. Foot Ankle 9: 163, 1989.

  • 11.

    Lagoutaris ED, Adams HB, DiDomenico LA, et al: Longitudinal tears of both peroneal tendons associated with tophaceous gouty infiltration: a case report. J Foot Ankle Surg 44: 222, 2005.

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 12.

    Freccero DM, Berkowitz MJ: The relationship between tears of the peroneus brevis tendon and the distal extent of its muscle belly: an MRI study. Foot Ankle Int 27: 236, 2006.

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 13.

    Rademaker J, Rosenberg ZS, Beltran J, et al: Alterations in the distal extension of the musculus peroneus brevis with foot movement. AJR Am J Roentgenol 168: 787, 1997.

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 14.

    Geller J, Lin S, Cordas D, et al: Relationship of a low-lying muscle belly to tears of the peroneus brevis tendon. Am J Orthop (Belle Mead NJ) 32: 541, 2003.

    • Search Google Scholar
    • Export Citation
  • 15.

    Eckert WR, Davis EA: Acute rupture of the peroneal retinaculum. J Bone Joint Surg Am 58: 670, 1976.

  • 16.

    Rosenberg ZS, Beltran J, Cheung YY, et al: MR features of longitudinal tears of the peroneus brevis tendon. AJR Am J Roentgenol 168: 141, 1997.

  • 17.

    O'Neill PJ, Van Aman SE, Guyton GP: Is MRI adequate to detect lesions in patients with ankle instability? Clin Orthop Relat Res 468: 1115, 2010.

  • 18.

    Park HJ, Cha SD, Kim HS, et al: Reliability of MRI findings of peroneal tendinopathy in patients with lateral chronic ankle instability. Clin Orthop Surg 2: 237, 2010.

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 19.

    Armstrong SJ, Wakeley CJ, Goddard PR, et al: Review of the use of MRI in soft tissue lesions. Clin Radiol 46: 311, 1992.

  • 20.

    Banks AL, Downey MS, Martin DE, et al: “Tendon Trauma,” in McGlamry's Comprehensive Textbook of Foot and Ankle Surgery, Vol 2, p 1687, Lippincott Williams & Wilkins, Philadelphia, 2001.

    • Search Google Scholar
    • Export Citation

Limitation of Magnetic Resonance Imaging in Diagnosing Longitudinal Peroneal Tendon Tears

Daniel Pollack Department of Podiatric Surgery, Wyckoff Heights Medical Center, Brooklyn, NY.

Search for other papers by Daniel Pollack in
Current site
Google Scholar
PubMed
Close
 DPM
,
Greg Khaimov Department of Podiatric Surgery, Wyckoff Heights Medical Center, Brooklyn, NY.

Search for other papers by Greg Khaimov in
Current site
Google Scholar
PubMed
Close
 DPM
, and
Ronald Guberman Department of Podiatric Surgery, Wyckoff Heights Medical Center, Brooklyn, NY.

Search for other papers by Ronald Guberman in
Current site
Google Scholar
PubMed
Close
 DPM

The purpose of this case study was to highlight a potential limitation of magnetic resonance imaging in diagnosing longitudinal tendon tears and to emphasize the importance of clinical examination for peroneal tendinopathy. We describe a 15-year-old female with lateral ankle pain, who was negative for peroneal tendon tear on magnetic resonance imaging. Owing to high clinical suspicion of peroneal tendon pathology, we opted to take the patient to the operating room and found a 6.5-cm longitudinal tear and a low-lying muscle belly of the peroneus brevis tendon. A low-lying muscle belly of the peroneal tendon has been shown to be associated with increased tendon tears.

Corresponding author: Daniel Pollack, DPM, Department of Podiatric Surgery, Wyckoff Heights Medical Center, 374 Stockholm Ave, Brooklyn, NY 11237. (E-mail: Dpollackdpm@gmail.com)